Fecal pancreatic elastase in infants under 2 years of age.
OBJECTIVE
Fecal pancreatic elastase determination is of routine use in infant population presenting with a neonatal diagnosis of cystic fibrosis and in those with poor weight gain and growth, in order to precociously detect pancreatic insufficiency. However, there are few data regarding the value of one spot measure of elastase to assess pancreatic status in this population. This retrospective study reports the follow-up of fecal elastase measurement in 236 infants during the 2 first years of life.


RESULTS
Fecal elastase was over 200 microg/g (i.e. normal cut-off) in a first sample in 122 patients (51.7% of patients) and below 200 microg/g in the remaining 114 patients. An alteration of elastase concentration was then observed in 18/122 infants (14.8%), leading to the diagnosis of pancreatic insufficiency at the end of the follow-up. In contrast, a normalization of fecal elastase was observed in 52 (45.6%) infants presenting with a first measurement below normal cut-off.


CONCLUSIONS
This study shows that special attention should be given to the analysis of fecal elastase concentrations in infants as a precocious diagnosis of pancreatic insufficiency is crucial for the early introduction of a pancreatic enzyme replacement therapy which will prevent further consequence of malabsorption. One spot measure does not totally exclude pancreatic insufficiency in this population and a further control measurement of fecal elastase may be necessary.
Benahmed
N A
NA
Laboratoire de coprologie fonctionnelle, APHP, Groupe hospitalier Pitié-Salpêtrière, Paris.
Manene
D
D
Barbot
L
L
Kapel
N
N
D000367:Age Factors; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis*; D005243:Feces / Q000201:enzymology*; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D010196:Pancreatic Elastase / Q000032:analysis*; D012189:Retrospective Studies; D013997:Time Factors
D010196:Pancreatic Elastase